• Tetsuo Takaya, Hidekazu Kato, and Mamoru Takiguchi.
• Department of Anesthesiology, Tokai University School of Medicine, Bohseidai, Isehara, 259-11, Kanagawa, Japan.
• J Anesth. 1996 Dec 1; 10 (4): 244-247.

AbstractTo determine the optimum priming dose of vecuronium, we divided 173 surgical patients into five groups according to priming dose (0, 2.5, 5.0, 7.5, and 10 μg·kg-1). For endotracheal intubation, we administered a priming dose of vecuronium, and then after 4 min, the remainder was injected for a total dosage of 0.15 mg·kg-1. Onset time was determined by a 95% depression of twitch height as shown by electromyography (EMG) of the hypothenar muscles. This was measured by repeating the train-of-four (TOF) stimulation. An increased priming dose shortened the onset time; however, this shortening rate diminished when the dosage was above 7.5 μg·kg-1. In the zero priming dose group there was a significant correlation between onset time and age, and between onset time and body mass index (BMI) in women (r=0.62 and -0.45, respectively); however, this correlation was not observed in men. A priming dose of 10 μg·kg-1 showed a decrease of TOF ratio to 95% or less in 1 out of 25 cases. Although one-third of the patients in the 5 and 7.5 μg·kg-1 groups complained of clinical symptoms such as ptosis, this was clinically allowable. We conclude that the optimum priming dose of vecuronium is 7.5 μg·kg-1; however, in obese patients, a smaller dosage would be recommended.

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